Friday, October 08, 2004

Flu Blues: My ears are still ringing from all the calls we've been taking this week about the flu vaccine shortage. No vaccine on the horizon for my patients. Although here's a community whose "flu clinics" gave all of their shots to doctors so they could be given to people who need them.

The vaccine shortage has made me wax nostalgic for my early medical days when, not only were there more vaccine producers, but the vaccine was given with discrimination, to only those who were at most risk for influenza complications. I can't recall any shortages of the vaccine back then. But then, we stopped being discriminating in our use of the vaccine. Companies began to buy up huge quantities of it to give to their young, healthy employees so they could cut down on absenteeism. Drug stores and grocery stores began to offer it to all comers - sometimes as a promotional gimmick. And the shortages began. There simply isn't enough margin of error in the vaccine supply to allow every man, woman, and child to get an influenza vaccine without compromising the access of those who need it.

But, even now, in the face of a shortage, the CDC continues to be overly optimistic about the supply:

Now the Agency apparently thinks its main job is covering its bureaucratic butt. Thus even as the CDC requested rationing, Gerberding insisted that since "we never vaccinate anywhere near" the target population of recipients, "50-some million doses we have now will come close to meeting this [the nation's] demand."

Grab that abacus! Last year we quickly exhausted the supply of 87 million doses. If we have no more than 52 million this year, we're already 35 million short of that – much less what would have been used had more been available. How would Gerberding define "NOT close"?

It also remains that we're 48 million vaccinations short of what the CDC originally claimed we needed. Is that also "close"?

And Another Thing: A reader points out that the current vaccine crisis holds lessons for drug reimportation:

Wonder why nobody asks the following question.

Everybody wants to import drugs from other countries to lower the cost, saying "hey those drugs are just as good as US versions."

Now that a prominent British drug producer has their ENTIRE supply of vaccine marked as suspect, do we still want to buy outside the US?

Good point.

CORRECTION: Chiron is an American company, it just has an overseas flu vaccine production plant. The point still holds, though. Importing our drugs from elsewhere, whether the parent company is American or not, still holds our drug supply hostage to regulatory agencies over which we have no control. (Think what would happen if a plant were in a country where bribery of regulators was common.)